Differential effectiveness between Ketamine and Esketamine: the predictive role of dissociative features. A treatment-resistant depression case.
Nicola Ragone, Barbara Barbini, Carolina Passani, Federico Seghi, Cristina Colombo
International Clinical Psychopharmacology July 7, 2023 DOI: 10.1097/yic.0000000000000497 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A patient with depression treated with both intravenous ketamine and intranasal esketamine |
| Interventions | Ketamine Esketamine |
| Topics | Depression Ketamine Esketamine |
| Keywords | Humans Antidepressive agents Depressive disorder, treatment-resistant |
| Key findings | The authors report that a patient experienced remission only with intravenous racemic ketamine, not with intranasal esketamine, and that dissociative symptoms were greater with intravenous ketamine. They propose that dissociative features may predict antidepressant efficacy, while noting that this possibility remains to be established. |
Abstract
More than 10 years ago, the discovery of the antidepressant effects of Ketamine opened the opportunity to develop a novel class of antidepressants. Ketamine induces dissociative symptoms as a major side effect. This rapid-acting antidepressant is available as an endovenous racemic compound and as an intranasal S-enantiomer: Esketamine; which is four-fold more potent for the NMDA receptor. Here we present the critical case of a patient who took both molecules experiencing remission just with endovenous Ketamine, whose impact in terms of dissociative symptoms was greater. In this short report, we discuss the differences between the two drugs and the possibility of dissociative features to predict their efficacy.
Comparable studies
Other case reports and case series on esketamine for depression, most cited first.
Citations in the library
Cited by 3
- Anhedonia: Current and future treatments Psychiatry and Clinical Neurosciences Reports March 1, 2025
- Listening to music during intranasal (es)ketamine therapy in patients with treatment-resistant depression correlates with better tolerability and reduced anxiety Frontiers in Psychiatry January 23, 2024
- Nitric Oxide Donor Sodium Nitroprusside Reduces Racemic Ketamine-But Not Esketamine-Induced Pain Relief. ACS Pharmacology & Translational Science July 12, 2024
Cites 12
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- Comparative efficacy of racemic ketamine and esketamine for depression: a systematic review and meta-analysis Journal of Affective Disorders September 23, 2020
- Do the dissociative side effects of ketamine mediate its antidepressant effects? Journal of Affective Disorders February 18, 2014
- Pharmacological and behavioral divergence of ketamine enantiomers: implications for abuse liability Molecular Psychiatry April 15, 2021
and 7 more in the library